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An epidemiological study of digoxin prescribing in general practice
The Journal of the Royal College of General Practitioners
|October 1, 1986
Summary
Long-term digoxin prescribing is often inadequate, with only 48% of patients achieving therapeutic serum levels. A critical review of digoxin therapy is recommended for all long-term users to optimize efficacy and necessity.
Area of Science:
- Cardiology
- Pharmacology
- General Practice
Background:
- Digoxin is commonly prescribed for elderly patients.
- Assessing the appropriateness of long-term digoxin prescribing is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the epidemiology of long-term digoxin prescribing.
- To assess the adequacy of prescribing, clinical status, and serum digoxin concentrations in patients on long-term therapy.
Main Methods:
- A study of 241 patients from six general practices.
- Assessment of initial prescribing reasons, clinical status, and serum digoxin levels (6-12 hours post-dose).
Main Results:
- Digoxin was most common in patients over 60 (90%).
- Prescribing reasons were adequate in only 55% of patients.
- Therapeutic serum digoxin levels (0.8-2.0 ng/mL) were found in 48% of patients; 46% were sub-therapeutic, and 6% were potentially toxic.
- No clear link between clinical well-being and serum levels.
- Supervision type (hospital vs. general practice) did not impact outcomes.
Conclusions:
- A critical review of long-term digoxin therapy is warranted.
- Dose adjustment or compliance improvement may enhance efficacy.
- Serum digoxin concentration measurement can aid evaluation, especially in sinus rhythm patients.